Intracr anial fungal granulomas: therapeutic considerations

ABSTRACT

Intracranial fungal granulomas are a rare entity. Extensive search of the national and international literature has revealed few reports. Despite newer imaging techniques and advancements in surgical and medical therapy, mortality remains very high. Delay in diagnosis due to non-specific presentation, failure to achieve complete surgical removal and delayed institution of antifungal therapy may be the contributing factors, however other factors need to be determined. Recently we have encountered three cases of fungal granulomas and observed that unlike other intracranial tumors, fungal granulomas do not distort the parenchymal architecture. The leave a tendency to spread along the base from one lobe into the other. These features may help to make a pre-operative diagnosis, proper surgical planning, early institution of antifungal therapy and may lead to a decrease in mortality rates